Thursday, 30 May 2013

The papers are full today of a report (initially carried by
the Daily
Mirror) about the first British man with dementia to have an assisted
suicide at the Dignitas facility in Zurich, Switzerland.

The BBC
is now running the story which will give it even wider coverage but it has also
been reported by the Telegraph,
Independent
and Daily
Mail. I have personally been asked to comment by the BBC, Mirror, Times (£) and
Telegraph.

This story (on which I originally
commented in March) is in the news because Michael Irwin (pictured), who
heads up the campaign group SOARS (Society for Old Age Rational
Suicide), gave an exclusive interview to
the Daily Mirror reporting that an 83 year old man with early dementia had
killed himself at Dignitas seven weeks ago. The Mirror then splashed it on
their front page. Now other news outlets are playing catch up in the usual
feeding frenzy.

Irwin claims to have ‘helped’ the (unnamed) man in question by
referring him to a London psychiatrist (currently also unnamed) who provided
him with a medical certificate to say that he was mentally competent enough to
make an informed decision about being helped to kill himself.

Irwin believes that assisted suicide should be available to
elderly people on demand and seems determined to make himself a martyr for the
pro-euthanasia cause by progressively pushing the legal boundaries so this case
was very helpful to his cause.

According to the Daily Mirror he now claims to have
helped at least 25 people to die at Dignitas.

In 2005 the General Medical Council found him guilty of
serious professional misconduct and struck him off the medical
register after he admitted supplying sleeping pills to help a friend die
although you will seldom see this reported.

Ever since, ironically and curiously, he seems to have
escaped prosecution by virtue of the fact that he is no longer a registered
medical practitioner. This is in spite of the fact that encouraging or
assisting a suicide remains a crime carrying up to a 14 year prison sentence
under the Suicide Act 1961.

This is because the Director of Public Prosecutions has
decided that he hasn’t yet fulfilled his prosecution
criteria. The problem this has created is that Irwin will go on annexing
the Sudetenland until he provokes a reaction from the DPP or police because he
sees that any reaction will give even more publicity to his cause.

However there is
now a new twist to the tale. In deliberately concealing the identity of the
London psychiatrist who issued the certificate of mental capacity to this
patient Irwin may well now be obstructing the course of justice.

The Director of Public Prosecutions makes it clear that
doctors acting in a professional capacity to assist a suicide are likely to be
prosecuted and the General Medical Council (GMC) has warned that such doctors
risk censure, including being struck off the medical register (see details of
DPP and GMC guidelines here).

That would seem to place the unnamed psychiatrist at risk of
both being prosecuted and also losing his licence to practice.

So at very least it
would seem that this case should be fully investigated by the police and the
GMC.

However on past
form I would expect that Irwin will make it extremely difficult for them. He
has cleverly, with the media’s full cooperation, created an unsolved mystery
that will run and run and ensure that he himself stays in the media spotlight.

The reason for this
is that Irwin is actually a campaigner who craves publicity. So he will talk to
the media when it suits him but will also withhold incriminating information
when it best suits his cause.

He is playing ‘catch me if you can’.

I suspect he would
quite like to be prosecuted to give his cause even more of the oxygen of
publicity and will continue to push the envelope more and more until he elicits
a response.

Those selling
newspapers are of course only too happy to oblige but in the process they risk
fuelling more anxiety and suicide contagion amongst the worried well.

What we learn from
Irwin is that pro-euthanasia campaigners will always push the boundaries. This
is because once you accept the argument that there is such a thing as a life
not worth living it is not possible to draft a law to encompass all who would
like to fall within its remit without eventually opening it up to everyone.

The minute assisted
suicide is allowed for anyone at all others will come using the same arguments
of compassion and autonomy with
allegedly equally deserving cases that fall just outside the existing legal
boundaries. And they will claim that in the interests of equality they should
have access to it too.

And so we see in
any jurisdiction where euthanasia or assisted suicide has been legalised that
incremental extension steadily takes place (eg Oregon,
Belgium,
Netherlands).

First there is a
year by year increase in numbers and then, accompanying this, a widening of the
categories of people to be included.

First we have
mentally competent, adults with less than six months to live (as Dignity in
Dying and Lord Falconer are pushing
for here). Then there are those who are ‘suffering unbearably’ (in mind or
body) but not terminally ill; then minors who are judged capable of making up
their own minds; then the mentally incompetent who ‘would have wanted it’ had
they been able to say.

Irwin wants assisted
suicide to be available not just for those who have early dementia, but for
any elderly people who feel that their time has come.

The problem is that
one cannot grant the legal right to assisted suicide to any group without at
the same time removing legal protection from other similar people.

If the law ever
were to change in this country vulnerable people would feel constrained
to end their lives for fear of being a burden upon loved ones. Or alternatively
loved ones would feel constrained to help their determined elderly relatives.

This pressure would be felt with real intensity at this time
of economic recession when many families are struggling to make ends meet.

Given the number of people and organisations who stand to
gain financially from the deaths of elderly people it would be a certain recipe
for personal and institutional elder abuse.

People with dementia and their families need the best
possible care and support, not campaigns for the removal of their legal
protection.

Our current law provides the right balance. On the one hand
the penalties it holds in reserve act as a powerful deterrent to exploitation
and abuse. On the other hand it gives discretion to prosecutors and judges in
dealing with hard cases. It does not need changing.

The odd thing about this whole drama is why this 83 year old man,
given his obvious mental capability, did not simply take his own life without
requiring assistance.

But then, had he done that, it would not have been an
international news story and would not have helped Michael Irwin’s campaign.

Tuesday, 28 May 2013

Two British Christians who refused to act contrary to
conscience have lost their legal battle at the European court of human rights
in a move that demonstrates that ‘gay rights’ trump ‘conscience rights’ when
the two conflict.

Ladele, 52, a local authority registrar, was disciplined by
Islington council in London for refusing to conduct civil partnership
ceremonies, while McFarlane, 51, a Bristol relationship counsellor, was
dismissed by the charity Relate for saying he might object to assisting same-sex couples with their sex lives.

The court had previously ruled that both employers' actions were
justified, given their obligations to prevent discrimination against people
using their services.

In 2003 Miss Ladele, who was being defended by the Christian
Institute, told her managers at Islington Council that, should civil
partnerships ever become law, she would have a conflict of conscience based
upon her Christian beliefs about marriage.

Following the introduction of civil partnerships, she wrote
to her employer in 2006 asking for a reasonable accommodation of her religious
objection to same-sex civil partnerships.

Islington accepted that it had enough registrars to provide
a civil partnership service to the public without requiring Miss Ladele’s
involvement. But managers at the council refused her request, and demanded that
she carry out civil partnership registrations against her will.

McFarlane, who was being defended by the Christian Legal Centre, had
practised as a relationships counsellor for a number of years. Then,
during a training course for a new skill, he was prompted to indicate
that if the situation ever arose he might have a
conscientious objection to providing sex therapy to a same-sex couple on account
of his Christian faith.

He was dismissed for gross misconduct for discrimination on the grounds
of sexual orientation, despite the fact that (i) the issue involved a
hypothetical scenario and (ii) there was never a risk of anyone being denied a
service to which they were entitled (since there were many other counsellors
who were willing and able to provide it).

The dismissal by Relate (his employer) was on principle and
it was irrelevant whether he could have been accommodated. A dismissal
for gross misconduct is the most severe sanction available to an
employer.

The two rulings demonstrate that under British law gay
rights now trump conscience rights and that reasonable accommodation need not
be made for employees. At a stroke this puts at risk the job of any employee
objecting to helping gay couples in activities they believe to be wrong (eg.
Celebrating a civil partnership, adopting a baby, having sexual counselling
etc).

The decision of the Grand Chamber has understandably prompted
calls for more robust protections to be put in place for Christians in the
Government's Marriage (Same Sex Couples) Bill. The House of Lords is due to
vote on the Bill at Second Reading next Monday 3 June.

It has been argued that if this latter bill goes through
those who refuse to endorse gay marriage (eg. Teachers, Council workers,
healthcare workers) could similarly find their jobs to be at risk.

Amidst the rulings however there were some rays of hope for
conscience rights.

The European Court decided that decisions of the UK Courts
were within the 'margin of appreciation' (discretion) that it allows to
national Courts - but in so doing it challenged many of the principles adopted
by UK Courts and asserted by the British government.

So for example, the UK Courts had held that beliefs about
marriage as between a man and a woman was not a core component of Christian
belief and so not protected. The European Court said that these beliefs were
part of Gary and Lillian's Christian identity and so were in principle
protected!

The British Government also suggested that because the
individuals were free to resign and find other jobs, there had been no
infringement of their freedom of religion - in other words, 'your freedom to
resign secures your freedom of religion'.
But the European Court ruled that 'freedom to resign and find another
job' is not sufficient to guarantee religious freedom.

These are significant
breakthroughs and will be a great help in contending for Christian
freedoms in the UK Courts in the future.

Last month the Council of Europe passed a resolution calling on all member
states to respect conscience and accommodate religious beliefs in the public
sphere. The situation facing UK Christians was recorded in the report that
was prepared for the debate that took place before the vote. This shows how the
cases have influenced Council of Europe opinion and consequent policy.

This month, a member of the EU Delegation to the
International Organisations in Vienna wrote:

‘We are concerned about rising anti-Christian intolerance
and violence... a trend which often remains unnoticed.’

Christians and others, living in a free democratic society, should not be
forced, at fear of losing their jobs, to do things they believe are profoundly
wrong. Instead reasonable accommodation should be made for them.

In both these cases it could have been, but the respective
employers decided instead, backed by the law, to put these two employees in an
impossible situation.

Whilst neither Ladele nor McFarlane were healthcare workers
the same principles will apply to doctors, nurses and others who find
themselves in similar moral dilemmas (I have previously
commented on the way that British law and employment regulations are
marginalising Christian health professionals).

Whilst we must not give up the fight these cases should not surprise us given
Britain’s progressive slide into secularism.

The Bible tells us that ‘everyone who wants to live a godly
life in Christ Jesus will be persecuted’ (2 Timothy 3:12). It is part and
parcel of following Christ, so best to prepare for it now.

Christians contemplating these circumstances need to draw a line in the sand and not be intimidated. In so doing they stand by biblical precedent.

The Hebrew midwives when ordered by the king of Egypt to kill all male Hebrew children refused to do so and as a result we are told that God commended and rewarded them (Ex 1:15-22).

Rahab the harlot similarly refused to co-operate with the king of Jericho in handing over the innocent Israelite spies (Jos 2:1-14). She is later praised for her faith in so doing (Heb 11:31; Jas 2:25).

Even the prospect of death as a consequence of disobedience to state law did not stop Shadrach, Meshach and Abednego refusing to bow down to the image (Dan 4:6-8), or Daniel persisting with public prayer (Dan 6:1-10).

In the New Testament when Peter and John were commanded by the Jewish authorities not to preach the Gospel they replied 'We must obey God rather than men' and went right on doing it (Acts 5:29).

We need to do the same and leave the eventual outcome in God's hands. Whether we are vindicated or condemned he will be glorified.

Monday, 27 May 2013

The search for what radicalised Michael Adebolajo (pictured)
and Michael Adebowale to kill soldier Lee Rigby in Woolwich last week is
leading increasingly to the influence of al-Muhajiroun leaders like Anjem
Choudary and Omar Bakri Mohammed.

Al-Muhajiroun is an Islamist group fronted by the radical
Luton-based cleric Anjem Choudary, which has been rebadged under a multitude of
brands since being proscribed by the previous government.

Its founder, Omar Bakri Mohammed, a Lebanon-based preacher,
who was banned from Britain and once ran courses in fighting jihad at a disused
nunnery in Sussex, claimed last week that he had converted Adebolajo.

As Jay Smith points out in a Pfander Films video
published this week, Adebolajo and Adebowale were in fact just taking the
Qur’an literally (See also Answering Islam here which makes the same point).

Smith asks why these two men killed this soldier, attempted
to decapitate him, pulled him into the street and then, without attacking
anyone else, waited around for the police to arrive before running into their
guns.

It’s all in the Qur’an, he says.

Sura 5:32, which was
ironically quoted this week by Nick Clegg in support of peace, was the very
verse that Adebolajo quoted to the cameras to justify his action:

‘whoever kills a soul
unless for a soul or for corruption [done] in the land - it is as if he had
slain mankind entirely’

Rigby was a British soldier in Afghanistan and some British
soldiers have killed Muslims. But killing one Muslim is like killing all
Muslims. It was British soldiers who killed Muslims so a British soldier and
not British civilians had to pay the price.

So what should a Muslim fighting jihad do with such people?
The answer in is Sura 47:4:

‘So when you meet
those who disbelieve [in battle], strike [their] necks until, when you have
inflicted slaughter upon them’

And the reward for losing one’s life in carrying out such
activity? Well, it’s Paradise, as explained in Sura
47:4, 5 & 6:

‘And those who are
killed in the cause of Allah - never will He waste their deeds… He will guide
them and amend their condition. And admit them to Paradise, which He has made
known to them.’

By shooting them without killing them the police denied
these two Muslims their actual aim, promotion to Paradise under the sight of
the world’s media cameras.

Theresa May and Nick Clegg cannot of course ban the Qur’an,
which is why they must seek instead to reinterpret it to claim that it is not
saying what these men believed it was actually saying.

But if we don’t like what happened on the streets of
Woolwich, it is perhaps the Qur’an itself, and not just al-Mihajiroun, that we should
be calling into question.

Adebolajo justified his actions as ‘an eye for an eye and a
tooth for a tooth’.

By contrast Jesus, when one his disciples (Peter) took up
the sword urged him to place it back in its sheath:

‘Put your sword back
in its place,’ Jesus said to him, ‘for all who draw the sword will
die by the sword’ (Matthew 26:52)

And he urged them not to follow the ‘eye for an eye’
directive but rather to ‘turn the other cheek’:

‘You have heard that
it was said, “Eye for eye, and tooth for tooth.”But I tell
you, do not resist an evil person. If anyone slaps you on the right cheek, turn
to them the other cheek also.’ (Matthew 5:38, 39)

The history of Islam began with bloody military conquest by
Muhammad and his followers.

But Christianity began with the death of Jesus (on
our behalf) and of his twelve disciples eleven gave their lives as martyrs
in his service because they preached the word of God rather than taking up the
sword. It was a peaceful revolution that conquered the Roman Empire through spreading love and the good news of Jesus' death and resurrection.

This is the same love and good news that Christians are called to spread today to all people whatever their age, sex, race, ideology or creed. And it is for this reason that I join many in condemning without reservation not only the Woolwich atrocity itself but also any violent reprisals against Muslims by any British citizens.

It is true that since the first century others have taken up
arms in the name of Christ. But this was never part of Jesus’ teaching. It was
however, according to the Qur'an, part of Muhammad’s.

10. No Kiwi batsman scored a pair in the match
(unlike Prior). OK I concede that Boult didn’t score any runs but he was not
out in the second innings.

11. Anderson in the first innings and Broad in the
second were in scintillating form and would have given anyone trouble. English captain Alistair Cook called it the best fast bowling he had ever seen and Broad said it was his best bowling ever. Kiwi skipper Brendon McCullum called it 'an hour of madness'.

12. England had to bat twice to beat us which South
Africa did not have to do in either test in January.

13. We still drew with England in a three match
series down under earlier this year so this is the first time they have managed
to beat us in four attempts.

15. We beat them
by 189 runs in the Hamilton test in the 2007-8 season in New Zealand so a
170 run victory is nothing to brag about.

16. There are three New Zealand teams in the top six
of the super fifteen after this weekend’s matches and we are still the rugby
world cup champions.

17. We have just won the 2013 IRB rugby sevens for the
11th time in 14 attempts with one tournament to spare.

18. We were the only football team to come home from
the last world cup unbeaten. Not even the eventual winners Spain could match
that.

19. We bowled England
out for 64 in the final innings of the 1978 test in the Basin reserve when
they only needed 137 to win the game. On that occasion Richard Hadlee took 6
for 26 against a team that included Boycott, Botham and Willis.

Saturday, 18 May 2013

'I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect.'

So reads the Hippocratic Oath, which until recently used to be taken by all graduating doctors.

Hippocrates of Cos (c.
460 BC – c. 370 BC) was an ancient Greek physician of
the Age of Pericles (Classical Greece), and is considered one of the
most outstanding figures in the history of medicine.

His oath at the time it was drafted was revolutionary.

Previously doctors had had the power to prescribe both remedies
and poisons. But Hippocrates, recognising their great power and the potential
for abuse, demanded that they should dedicate themselves solely to
healing.

Along with the Judeo-Christian ethic the Hippocratic Oath
has formed the basis of every code of medical ethics since 400 BC; that is
until now.

Lord Falconer, who has just introduced his ‘Assisted
Dying Bill’ into parliament this week (see timetable here), is seeking to change 2,400 years of
history.

His bill would make it legal for doctors to help mentally
competent adults with less than six months to live to kill themselves. Two
doctors would need to agree that a patient met the criteria and the option would
not be open to minors, people without mental capacity or those who are not
terminally ill.

The final step would involve a doctor (or nurse)
hand-delivering lethal drugs to the patient at a time and place of their
choosing and staying with them while they took the drugs and until they were
dead.

But as an article
in the Times (£) accompanying the above letter notes, the British Medical
Association and almost all Royal Colleges are opposed to a change in the law.
In fact about two thirds of doctors are opposed.

Interestingly, the Times newspaper, is in agreement with
them.

In its editorial
(£) today it says it would be ‘wrong to legislate’ and that ‘the law that Lord
Falconer now wants is a step too far’.

The current blanket prohibition on assisted suicide keeps
the numbers low, as evidenced by the very low numbers of people travelling to
Dignitas facility in Switzerland to kill themselves.

Furthermore the Director of Public Prosecutions (DPP)
already has discretion not to prosecute in hard cases and the authority to temper
justice with mercy. But he is particularly tough on doctors, because of the power they have, as recognised by Hippocrates.

‘There is a danger’, argues the Times, ‘that a codified law
that attempted to replace such difficult and nuanced judgments with statute
would produce two problems.’

‘The first is a large
increase in assisted suicides as it becomes more legally straightforward. This
is the reason why many lobbyists for the disabled oppose the Bill, concerned
that people will be put under pressure to end their lives.’

‘The second danger is,
oddly, an increase in prosecutions for assisting suicide, as the discretion of
the old system is replaced by a more formulaic approach. This may be the reason
why doctors are, in general, against a new law. And why they are right to be.’

It is significant that the Times, which backed a change in
the law at the time of Falconer’s last attempt to alter it in 2009 has now
changed its position.

But it has done so on the basis of good evidence.

Jurisdictions which have legalised either assisted suicide
or euthanasia, have seen a steady increase in case over subsequent years and
the widening of criteria to include categories of people for whom it was never
intended.

Our current UK law is clear and right and does not need
changing. The penalties it holds in reserve act as a powerful disincentive to
exploitation and abuse, whilst giving both prosecutors and judges discretion to
temper justice with mercy in had cases.

It may not be perfect, but we tamper with it at our peril.

And Hippocrates was right about doctors too. They are too
powerful and too human to be given the power and authority to kill.

Friday, 17 May 2013

Various media outlets (including The Times (£), The Telegraph, BBC, The Independent and The Guardian) have published articles reporting on how
fertility specialists from Nottingham have developed a radical technique that
will ‘dramatically improve’ the chances of IVF couples having a baby.

About one in eight couples have trouble having children
through natural conception and around 48,000 women currently undergo IVF
treatment each year resulting in about 12,200 IVF births, an overall success
rate of 25%.

This failure rate of 75% causes immense emotional upset to affected
couples, many of whom have paid between £5,000 and £10,000 for each treatment
cycle.

However the new
procedure, which uses ‘time-lapse imaging’ to monitor the health of
embryos by taking thousands of digital pictures to identify ones that are
developing well, could raise the chance of a live birth to 78%, about
three times the national average.

The new technique identifies the ‘best embryos’ to be
implanted into the womb based on the time it has taken to develop between two
key stages in the early life-cycle of the embryo.

Thousands of time-lapse pictures taken during the first few
days of an IVF embryo's life are used to identify the time between the first
appearance of the fluid-filled cavity, called the blastula (normally 97 hours),
and the full blastocyst (122 hours).

In embryos at high risk of aneuploidy (extra chromosomes)
these steps occurred about 6 hours later on average. Aneuploidy is the single
biggest cause of IVF failure.

To test the system, the doctors ran the program on
time-lapse images of 88 embryos that had been recorded previously for 69
couples at the clinic. Some 61% of the embryos ranked as low risk for abnormal
chromosomes led to live births, compared with none of those ranked as high
risk.

Around a
dozen private and NHS clinics are currently using time-lapse embryo imaging. It costs
around £750 in addition to about £3,000 for IVF.

The £750 cost compares favourably with the current cost of £2,500
for Pre-implantation Genetic Screening, an invasive test which removes cells
from the early embryo for analysis.

If the new imaging test proves to be effective in larger
trials it seems likely that it will be used much more widely.

What is singularly lacking from any media coverage of this
research however is any discussion of the ethics.

Not only does it seem to be taken for granted that the
improved success rates override any ethical objection. There is simply no
ethical objection even considered.

But let’s think about what is actually happening here.

Embryos are being created in a laboratory and those with
aneuploidy are being identified and discarded.

Some of these will have the
commoner trisomies (three rather than two copies of a particular chromosome) –
Down’s syndrome (trisomy 21), Edward’s syndrome (18) and Patau’s syndrome (13)
– where affected babies are often born alive.

Some will have other trisomies (like trisomy 15, 16
and 22) and inevitably will either fail to implant or result in miscarriages.

So is it right to implant those embryos more likely to
survive and throw away the others?

Well that surely depends on what these tiny organisms
actually are.

They are undoubtedly individual human lives, but what status
do they have? Are they potential human beings or are they human beings with
potential?

Philosophers like Singer, Glover and Harris will tell you
that they are alive but non-persons because they do not yet have functioning
nervous systems.

But others, who would argue that human life from the time of
fertilisation should be shown the utmost respect and afforded protection would
say that every living human organism – no matter how young, old or disabled and
regardless of its intellectual capacity – is also a human person with rights.

I know what
I think, but what do you think and why? They are either persons or not
persons. Which is it?

Is this new technique the 'most exciting breakthrough in IVF
treatment in 30 years'? Or is it just eugenics by another name?

Thursday, 16 May 2013

The newspapers are full today of the news that scientists in
the US state of Oregon have produced embryonic stem cells (ESCs) using the same
cloning technology (somatic cell nuclear transfer (SCNT)) that created Dolly
the sheep.

The original paper was published in the scientific journal Cell (Reuters
and Nature
give helpful reviews).

Shoukhrat Mitalipov and his colleagues took skin cells and
transplanted their nuclei into eggs from paid donors from which the nuclei had
been removed. Some resulting embryos were grown to the blastocyst stage (about
150 cells) at which point embryonic stem cells were harvested and developed
into stem cells lines from which a range of more specialised body cells were
derived.

Some are claiming that this might be the first step in producing
stem cells that can be used to treat conditions in which there is cell loss like
Parkinson’s, diabetes and spinal cord damage.

The huge media coverage this story has generated is due to
the obsession of the British media with embryonic stem cell technology, the
fact that this is the first time embryonic stem cell lines have been derived
from cloned human embryos and the emotion generated by conditions for which
there is currently no cure.

Amidst the hype let me register six reasons for caution.

First, what many news outlets do not make clear is that these
embryonic stem cells have been produced by the cannibalising of cloned human
embryos, a process that results in their destruction. This is a huge ethical
barrier to the technology for those who believe, as I do, that human life
begins at conception.

Second, the paper discloses that ten women were paid to
‘donate’ more than 120 eggs in the course of the research. The primary means by
which these eggs are procured is ovarian hyperstimulation which is associated
with serious
health risks in both the short and long term. Egg donors for the experiment received
US$3,000–7,000 in compensation. This is expensive and risks creating an
organ trade that preys on the poor, especially students. Jennifer Lahl’s
excellent book ‘Eggsploitation’
spotlights the booming business of human eggs told through the tragic and
revealing stories of real women who became involved in selling their eggs.

Third, the method used to create these embryos is identical
to that used to create cloned adults. If someone were to implant one of these
embryos in a woman it could theoretically be grown into a cloned baby. Such
portakabin technology is extremely difficult to police and some like Dr David King, from the
campaign group Human Genetics Alert, are saying for this reason that it should
not be done at all.

Fourth, we know already that cloned mammalian embryos are not
normal because they do not grow into normal adults. It took 277 attempts to
create Dolly the sheep and she was abnormal and died early. This raises the
strong possibility that stem cells derived from cloned embryos may not be
normal either. This means that they are very unlikely ever to be used in treatments but only in research. It is adult stem cells derived from sources like umbilical cord blood and bone marrow that hold the real promise, are involved in the overwhelming majority of clinical trials and are already being widely used in treatment of a wide range of conditions.

Fifth, there is already alternative stem cell technology
available for research. Induced
pluripotent stem cells (iPS) (which can be made from reprogrammed adult
cells without the need to create and destroy embryos) and for which Japanese researcher Shinya
Yamanaka won a Nobel prize in 2012, have already led many researchers to
abandon research using cloning methods. Although this research is still at an
early stage iPS cells appear to have most of the properties of embryonic stem
cells and their production does not involve the same ethical barriers.

Finally, this new research is at a very early stage and we
need to beware of the huge media hype that will be generated around it by
biotechnology companies and scientists who have financial and personal vested
interests and a hotline to the media. We need to be wary that we are not being
given an exaggerated account which is high on hype and plays down the real
risks.

Monday, 13 May 2013

In an interview this morning on BBC Five Live (at 0705) on
the Paul Lamb case (listen here) I was asked by the presenter Nicky Campbell about evidence
for a slippery slope following the legalisation of euthanasia in other jurisdictions.

In my answer I mentioned the steady escalation in numbers of
cases in Belgium and the Netherlands (see here
and here)
and said that one third of nurses had carried out euthanasia illegally in
Belgium and that one third of cases in some parts of Belgium had been involuntary
although the law did not allow this.

I also mentioned the ‘Groningen Protocol’
under which disabled babies had been given lethal injections in the
Netherlands.

Campbell appeared not to know about this and asked me on air to email him information about it to which I agreed. Another BBC journalist phoned me after the interview to check my sources.

It says that ‘Twenty-two cases of euthanasia in newborns
have been reported to district attorneys' offices in the Netherlands during the
past seven years’ but also highlights underreporting:

‘Given that the
national survey indicated that such procedures are performed in 15 to 20
newborns per year, the fact that an average of three cases were reported
annually suggests that most cases are simply not being reported.’

The 22 babies killed all had spina bifida and/or
hydrocephalus – conditions which many disabled people live with in Britain
today (Here is another report
on the protocol from CBHD citing the 22 documented cases).

A more recent report suggests there has been a reduction in
cases of direct newborn euthanasia in the Netherlands since 2005 because of 1.
More efficient prenatal detection and late abortion 2. More use of ‘terminal
sedation’ not recorded officially as euthanasia 3. Continued underreporting

3. A recent study found
that in the Flemish part of Belgium, 66 of 208 cases of ‘euthanasia’ (32%)
occurred in the absence of request or consent.

4. According to arecent reportBelgium is now the ‘world leader’
in organ removal after euthanasia withat least nine
cases since 2005but
suggestions are that there would have been many more had more euthanasia
patients had transplantable organs.

7. The latest Lancet
paper on the subject giving 12.3% as the figure for terminal sedation
deaths in the Netherlands and summarising other past papers in NEJM/Lancet

I gather that Nicky Campbell has since agreed
on twitter with my opponent in the interview (Andrew Copson of the British
Humanist Association) that I was ‘a past master in extreme and irrelevant
claims’ (I'd be interested to hear his evidence for that btw) but at least he will be able to verify the truth of my claims about euthanasia in Belgium and the Netherlands from the links
given above.

Saturday, 11 May 2013

The 20th Century was defined by economic and class-based
divisions between socialists and capitalists. But with the main political
parties now increasingly embracing free market capitalism and in the absence of
an argument about economic management, culture rather than economics will be
the future's defining political divide. The 21st Century will be defined by
cultural and social divides, between liberals and conservatives.

American culture wars are already being fought. Liberals
embrace abortion, gay marriage, drug legalisation, sexual permissiveness,
embryo research, euthanasia, easy divorce, cohabitation, political correctness,
positive discrimination, government interference, and higher taxes and spending
to pay for welfare; Conservatives most likely go to church and oppose all of
the above. The best predictor of whether a white American voted Republican in
2000 was church attendance more than once a week – 79 percent of this group
voted Bush.

By contrast, British liberalism reigns largely unchallenged.
Small victories are won – the government defeat over the Racial and Religious
Hatred Bill, and the rejection of the Joffe Bill – but the general policy
thrust, both Conservative and Labour, is liberal. Daily, the headlines are
dominated by yet another liberal triumph. Cohabiting couples are to have equal
rights as the married; churches and mosques are to be forced to rent out their
premises to homosexuals; under-age sex is actively encouraged by the media;
single parent families are to be admired as much as married families;
drug-taking celebs are condoned; Christian teaching is thought freakish and
extreme; and the Human Rights Act makes a mockery of the criminal justice
system to the point of virtual collapse of law and order.

The British liberal establishment is now so powerful that it
is a wonder we keep winning the euthanasia vote. Government departments,
institutions, the media, and even medical journals and organisations like the
BMA are increasingly influenced by powerful liberals. As a result, Christians
are increasingly marginalised, left without a voice, by the new establishment.

Many UK Christians will have reservations about some of the
issues supported by our brethren in the US. Christian morality is in some ways
a strange mixture of right and left wing politics – mixing traditionally left
wing concerns for the poor, disabled, ethnic minority groups and developing
world with a more traditionally right wing opposition to abortion, euthanasia
and sexual immorality. The common factors we would want to emphasise are a
concern for the vulnerable and marginalised, and recognition that those most
easily exploited need to be both strengthened and protected.

But following in the footsteps of Christ in these days
involves both the willingness to speak out on behalf of the voiceless, and the
willingness to suffer and expend energy on their behalf. And to do that
effectively, we need to be involved at every level of society, not only at the
grassroots, but also in the media and institutions.

Wednesday, 8 May 2013

Lord Falconer has finally announced that his long awaited
assisted suicide bill will be tabled in the House of Lords next week on
Wednesday 15 May.

It is then that we will finally see the full text of the bill
which will then proceed to second reading (debate stage) sometime in June, or
possibly in the autumn.

According to the BBC and Telegraph
the bill will be based on theOregon model– assisted suicide for mentally competent
adults who have less than six months to live.

The
timing has been carefully planned. On 13 and 14 May the Court of Appeal will be
hearing the case of Paul
Lamb, a 57 year old man with quadriplegia, who is seeking permission for a
doctor to kill him by means of a lethal injection.

Off
the back of media coverage of this case, Falconer, who is being backed by
Dignity in Dying (the former Voluntary Euthanasia Society), will argue that his
proposal is modest in comparison.

Lamb
is not terminally ill and wants a doctor to give him a lethal injection
(euthanasia). Falconer however is only asking for people who are
terminally ill to have the right to receive help to kill themselves (assisted
suicide).

This
model, he will argue, will be safer for vulnerable people and will have
‘upfront safeguards’ to stop abuse.

According
to House of Lords calculations in 2005 a Dutch-type law (such as Lamb is
seeking) would mean 13,000 euthanasia deaths a year in Britain, but an Oregon-type law (like Falconer’s) would mean only 650.

Falconer
is thereby attempting to position himself as the reasonable middle ground
between those who wish to keep euthanasia and assisted suicide illegal and
those who want extensive decriminalisation.

We
should not be fooled by this ploy and the situation in Oregon is already
ringing loud alarm bells.

Members of the House of Lords should note that statistics
released just earlier this year (full reporthere) show that the number of assisted
suicide prescriptions and deaths in Oregon, once again, increased in 2012 and
has now reached an all-time high.

There were 59 assisted suicide deaths in Oregon
in 2009, 65 in 2010, 71 in 2011 and 77 in 2012; a 30% increase overall in just
four years.

The number of prescriptions for assisted suicide
was 95 in 2009, 97 in 2010, 114 in 2011 and 115 in 2012; 115 in 2012; a 21%
increase since 2009.

Overall assisted suicides have gone from 16 in
1998 to 77 in 2012, an overall increase of 381% (see chart above).

The Oregon numbers may not seem large but we
need to remember that Oregon has a very small population relative to the UK and
that they may well be anunderestimateas they are based on physicians'
self-reporting.

But for argument's sake let's simply take them
at face value. How would they then translate to Britain?

Back in 2006, and based on Oregon’s total of 38
assisted suicide deaths in 2005,the House of Lords calculatedthat with an Oregon-type law we would have
about 650 cases of assisted suicide a year in Britain.

But as the numbers in Oregon have since doubled
to 77 the UK equivalent would now be 1,300.

We should learn from the Oregon experience and
be resisting these moves.

Any change in the law to allow assisted suicide
(a form of euthanasia) would inevitably place pressure on vulnerable people to
end their lives so as not to be a burden on others and these pressures would be
particularly acutely felt at a time of economic recession when many families
are struggling to make ends meet and health budgets are being slashed. Especially when fears about the NHS are actually fuelling support for assisted suicide. The so-called right to die can so easily
become the duty to die.

And once legalised there will inevitably be
incremental extension as we have seen in Oregon, Switzerland, Belgium and the
Netherlands. Legalisation leads to normalisation. New hard cases will brought to
bring pressure to widen the existing criteria to allow extension to ‘Gillick
competent’ minors, people without mental capacity who ‘would have wanted it’ and
those who are ‘suffering unbearably’ but are not terminally ill.

Also deeply concerning are reports ofdepressed patients being killed without being treated, doctor
shopping, deaths taking place without witnesses present (raising questions
aboutelder abuse) and the fact that 44 of the 77 who died
last year (57%) said that they were concerned about being a burden on family,
friends and caregivers.

The lessons are clear. Let’s not go there.

The best system is what we have already – a blanket ban on
both assisted suicide and euthanasia which provides a strong deterrent to
exploitation and abuse whilst giving discretion to both prosecutors and judges
to temper justice with mercy in hard cases.

Under this the number of people going to the Dignitas
facility in Switzerland to end their lives remains a trickle of about 15-20 per
year.

So let’s keep that system in place and concentrate on
providing the best possible care to people who are dying. Let’s major instead on
killing pain without killing the patient.

She quoted from my blog in order ‘to demonstrate to members
the type of tactics used to discredit voluntary assisted dying schemes in
operation overseas’ and said that it was ‘a great lesson in lies, damn lies,
and statistics’ ( I think she meant ‘lies, damned lies and statistics’ just as she meant to say ‘Philip Nitschke’
and not ‘Philip Nietzsche’)

In order to put the record straight I have reproduced the
statements she made in her speech here along with my rebuttals so that it is
apparent who was really distorting the truth. The quotes from her speech are in
italics.

‘The material
circulated was an article headed “Stunning 4,620% increase in Belgian
euthanasia cases in ten years since legislation” by Peter Saunders… As Saunders
says, the number of euthanasia deaths in Belgium has increased from 24 in 2002
to 918 in 2011. However, he has miscalculated the percentage increase.
The increase in the ten years is 918-24, which is 894. So firstly
the percentage increase is 3,725% not 4,620%.’

Faehrmann has here confused the figures. The graph in my
article (reproduced above from the recent FCEE report for 2010 and 2011) has three lines, one representing euthanasia cases in
Flemish-speaking Belgium, one for French-speaking Belgium and an overall total.
The figures I gave were the overall total for 2002 (24) and 2011 (1,133). This
is actually an increase of 4,620% as I said. Faehrmann has taken the overall
total figure for 2002 (24) but the Flemish figure for 2011 (918) to derive her
incorrect percentage increase of 3,725%.

Additionally, Belgian
euthanasia laws weren’t passed by parliament until late September 2002, which
means the 24 deaths that year were in the last 3 months. That’s why the figure
is relatively low. But the following year was 235, so arguably that should be
the base line number. So that’s more like a four-fold increase from 2003 to
2011.

This is a fair point but does not alter the fact that the
annual figures in the Belgian report did actually increase 4,620%. However if
we multiply the first 3 month figure of 24 by 4 to get 96 then the increase
over ten years to 1,133 is still 1,080%. Even if we take the total for the
first full year (2003) as she
suggests (235) and include the figure for 2012 (1,432) then the ten year
increase was 509.4%. Is she really suggesting that this level of increase is
acceptable?

‘Of course, this
percentage increase still seems large. But presenting the figures in this way
is misleading. It stands to reason that in the first few years after the
introduction of the legislation the number of euthanasia deaths would be low
since the system took some time to be understood by both the medical profession
and the public. Once it was more established annual deaths under the
scheme began to increase by about 100 a year to the present level of 918, but
that figure comprises only 1% of total annual deaths in Belgium according to
Saunders' own source.’

Since 2007 the annual rises have been 209, 118, 131, 180 and 299 –
much bigger than ‘about 100 a year’ - with each annual rise (but one) greater
than the last.

‘Another way of
expressing the increase in Belgium is to say that between 2002 and 2011 the
percentage of deaths for euthanasia increased from 0.026% of total deaths to 1%
of total deaths – hardly “opening the floodgates”!’

Or you could say that the annual number of deaths went from
235 to 1,432 per year in ten years. If this fivefold increase does not ring alarm
bells with her then we do have a problem. Although she has placed the words
‘opening the floodgates’ in quote marks I didn’t actually use these words.
Instead I said that ‘once euthanasia is legalised steady escalation follows
along with a change in the social conscience so that it rapidly becomes
accepted as normal’. I have previously highlighted the similar escalation
of euthanasia and assisted suicide cases in the Netherlands, Oregon and Switzerland in
recent years.

‘Saunders’ other
unsupported assertion is that the FCEC is now considering “extending the right
to citizens who suffer from degenerative mental illnesses like Alzheimer’s and
also to children”.’

In fact this assertion was not unsupported at all. The full
facts and references to the original Belgian source documents can be found here
along with previously
documented reports from Belgium showing that half of cases go
unreported, half of Belgian euthanasia nurses have killed people without
request, one third of euthanasia cases in at least one region are involuntary
and that euthanasia cases are now
being used as organ donors.

A report published late last year by the Brussels-based European
Institute of Bioethics claimed that euthanasia was being ‘trivialized’
and that the law was being monitored by a toothless watchdog. After ten years
of legalised euthanasia and about 5,500 cases, not one case had ever been
referred to the police.

Cate Faehrmann may be passionate about euthanasia but it is a very serious thing for an MP to mislead parliament, especially in
introducing a bill.

I am asking her to retract her accusation of ‘lies, damned lies and statistics’, to issue an
apology and to correct the errors and omissions in her published speech.

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Kiwi, Christian and Medical

This blog deals mainly with matters at the interface of Christianity and Medicine. But I do also diverge into other subjects - especially New Zealand, rugby, economics, developing world, politics and topics of general Christian and/or medical interest. The opinions expressed here are mine and may not necessarily reflect the views of my employer or anyone else associated with me.

About Me

I am CEO of Christian Medical Fellowship, a UK-based organisation with 4,500 UK doctors and 1,000 medical students as members. The opinions expressed here however are mine, and may not necessarily reflect the views of CMF or anyone else associated with me.